be made. (c) In the third stage, viz., that of suppuration, incisions should be made. If the abscess be small, the incisions should also be small, compression by means of collodion should be exercised over the rest of the swelling, and the edges of the wound should be kept apart. In cases where there is extensive suppuration the incision should be large, cicatrisation should be so managed as to prevent the formation of disfiguring and hurtful scars. The chancrous bubo should be treated by poulticing, incision when pus has formed, slight pressure, and if necessary, injection with nitrate of silver. In doubtful cases, treat as for chancrous bubo. (Thèse de Paris, No. 409, 1879; The Glasgow Med.Journal, April, 1880.)

On Catching Cold.-Dr. Lassar has attempted, by experiments upon animals, to determine the physiological effects of catching cold. By means of hydrated calcium sulphite he removed the hair from rabbits, an operation which does no harm so long as they are kept in a warm room, although if they be exposed to cold the same consequences follow as if the skin were varnished over. After watching the condition of the animals and observing their urinary secretion for some days at a temperature of about twenty degrees centigrade, he found that little change took place if the temperature were kept for fifteen to twenty hours at thirty-four or thirty-five degrees centigrade, excepting that the temperature of the animal rose from about a half to one degree, again falling when the aniinal was once more put under normal conditions. The result was very different, however, when a rabbit deprived of its hair was suddenly taken out of a warm room and held up to the neck for one to three minutes in ice-cold water. The temperature in the rectum always sank more or less after this proceeding, according to the duration of the immersion, and sometimes fell as low as thirtytwo degrees centigrade. After the animal had been carefully dried, rubbed, and placed in the heat of the sun or of a stove, it continued to shiver, sometimes for hours, but if it was put in an atmosphere of about twenty degrees centigrade, it recovered and soon after was apparently all right. Violent but transitory diarrhoea occasionally occurs. One of the most remarkable results, however, is that after one or two days albumen almost invariably appears in the urine and is accompanied by hyaline tube casts. The quantity of albumen is at first very small, afterwards becomes greater, and may become very large, at the same time the temperature rises, so that in the rectum it may be one to five degrees centigrade above the normal. In many cases the albuminuria only lasts a few days, then diminishes, and finally disappears. Sometimes, however, it continues for weeks, or even months, up to the death of the animal. Whenever the

animal that has recovered from albuminuria is again exposed to cold, the albuminuria reappears. Microscopic examination of the organs in which no peculiarity could be observed by the naked eye constantly showed the results of the chill in interstitial inflammation, especially in the kidneys and liver, but also in the lungs, heart, and sheaths of the nerves. With the exception of a slight artificial eczema on one occasion, the skin was never affected in the least. The muscles sometimes showed an abnormally red colour, but there was no increase of the nuclei nor of those of the sarcolemma.

The joints in all cases were absolutely unaffected, a circumstance which supports the Senator's distinction between muscular and articular rheumatism. With the exception of a slight fatty condition, which did not overstep the normal limit, the parenchyma of the inflamed organs was unaltered, but on the other hand, the vessels, especially in the lungs and liver, were often enormously dilated, the arteries filled with thrombi, and in the neighbourhood of the veins, as well as in the connective tissue interspaces, leucocytes had wandered out of the vessels in great numbers. On repeating the experiments with rabbits from which the hair had not been removed, similar results were obtained, as well as with young puppies, and even with frogs. When pregnant rabbits were used for experiments, inflammatory changes could be observed by the microscope, although not with the naked eye, in the liver of the foetus, as well as of the mother. These inflammatory changes in the adult animal were chiefly round the vessels, and the author believes that they are due to the blood, which has been suddenly cooled in the skin, returning to the internal organs, and there acting as an irritant. (Virchow's Archiv. Band 79, Heft. 1.)

Inflammation of the Auditory Meatus.-Dr. Buck sums up the relative merits of the different measures most commonly employed in the treatment of acute circumscribed inflammation of the external auditory canal, including furmicles, as follows: "Incisions cannot be depended upon to give permanent relief from pain, or to materially shorten the course of the disease. They should therefore be only used after local blood-letting or hot applications have been faithfully tried without success, or where the appearance of the inflamed part indicates the probable formation of a collection of pus. The application of heat is preferable to local blood-letting by leeches. Of the various means at our command for applying heat to the inflamed part, the pleasantest, and at the same time the most effective, is the hot douche. In a few cases, however, the patient finds some form of dry heat more effective in relieving the pain." (The American Journal of Otology, Jan. 1880.)

Primary acute Purulent Inflammation of the Middle Ear. Dr. H. Knapp, of New York, makes the following suggestions respecting the causes and treatment of this disease: Amongst causes, exposure to cold furnished nearly 64 per cent. of his cases, from extension to the middle ear of inflammation originating in the naso-pharyngeal mucous membrane. Sea-bathing follows with about 9 per cent. The low temperature of the sea water entering the meatus, the large proportion of salt contained in it, its contamination with sand, slime, small plants and animals, and lastly the great loss of heat to the entire body to which the bather is subjected, are amongst the reasons given to account for the occurrence. Next follows scarlet fever, with about 7 per cent.; diphtheria 2 per cent.; measles and pneumonia 11 per cent. Discharge from the ear, corresponding with perforation of the drum head, begins usually in from two to three days from the exposure, but may be delayed till the seventh or fourteenth day. Respecting treatment Dr. Knapp insists strongly on the necessity of rest in bed from the first, to secure perfect restoration. If otorrhoea have not set in 2-6 leeches should be applied behind the ear and hot water be poured into it at intervals; aperients to be given. After discharge has set in, should it suddenly cease, which means a more intense return of inflammation, accompanied with pain, fever and vertigo, steaming the ear is most effectual. Should this not succeed, Wilde's incision over the mastoid must be practised. The naso-pharyngeal membrane and Eustachian tubes should receive constant attention. Astringent solutions (arg. nit., alum tannin, sulphate of zinc 1-3 per cent.) are to be used as gargles, nose waters, or by the nebuliser or posterior syringe. Politzer's process should always be employed, also careful syringing of the meatus with lukewarm water containing soda carb. to keep the external canal perfectly clean. Later on weak astringents. Polypoid granulations are thus prevented. (Archives of Ctology, May, 1879.)

F

NO. CXLV.

Notes and Queries.

ON LARGE DOSES OF MORPHIA HYPODERMICALLY.-We have received the following communication on this subject from Dr. Heywood Smith:-"The tolerance of morphia can be carried far beyond the quantities given in the cases brought forward by Mr. Robert Park in the Practitioner for June. In 1872 I had a patient, aged sixty-six, who had had nine children and one miscarriage (the last pregnancy being twenty-five years previously), who was the subject of a rather rare form of malignant ulcer of the cervix uteri, more like lupus. She had been ailing five to six years, and latterly suffered very severe pain. I used often to inject her three times a day with six grains of morphia at each injection, and one day I gave her four such injections, making twenty-four grains in twenty-four hours. This just relieved the pain and did not produce much sleep. Her tongue remained for a long time quite clean, and her appetite fair."

CHRISMA. We have received from Messrs. Allen and Hanbury a substance bearing this name, and intended as a basis for ointments. It is of a light primrose colour, devoid of smell and taste, and consists of a solid hydrocarbon obtained from petroleum. In its properties it resembles very closely Vaseline and other substances of the same class. Like them it cannot become rancid, and it forms a much better basis for many ointments than fat or oil, and may also be used pure as a substitute for simple ointment or glycerine.

SELF-RAISING FLOUR.-In this flour, a specimen of which we have received from Messrs. Macdougall and Co., the power of raising the bread or pastry by the evolution of gas during baking is conferred by the presence of acid phosphates instead of by acids or by fermentation. As phosphates play a considerable part in the nutritive processes of the body, their presence is likely to be useful rather than injurious. We have satisfied ourselves that the flour is most useful for making pastry; indeed it rises so well that with it light pastry is made by cooks whose pastry is so heavy as to be uneatable when made with ordinary flour.

Bibliography.

Montreal General Hospital Reports, Clinical and Pathological by the Medical Staff. Edited by William Osler, M.D., M.R.C.P. Lond. Vol. I. Svo. pp. 369. Montreal: Dawson Brothers.

On Consumption, and its Treatment by the Hypophosphites. By John C. Thorowgood, M.D. Third edition. 8vo. pp. 88. London: Baillière, Tindall, and Cox,

Notes on the Diseases of the Testis. By Samuel Osborn, F.R.C.S. Fcap. 8vo. pp. 117, with engravings. 3s. 6d. London: Churchill.

An Elementary Treatise on Practical Chemistry and Qualitative Inorganic Analysis. Third edition. By Frank Clowes, D.Sc., London. Post 8vo. pp. 353, 48 engravings. 7s. 6d.

London Churchill.

A Clinical Lecture on Absorbent and Antiseptic Surgical Dressings. By Sampson Gamgee, F.R.S.E. 8vo. pp. 18, with engravings. 1s. London: Churchill.

Indigestion: What it is, What it Leads to, and a New Method of Treating it. By J. B. Gill, M.D. Fcap. 8vo. pp. 249. 3s. 6d. London: Churchill.

Surgical Emergencies. Third edition. By W. P. Swain, F.R.C.S. Crown 8vo. pp. 220, 117 engravings. 5s. London: Churchill.